Torrey Pines Oral & Maxillofacial Surgery

Is Wisdom Tooth Surgery Necessary?

Surgical management of impacted third molars (wisdom teeth) is a common treatment frequently offered in oral and maxillofacial surgery offices.

Despite how common the treatment is, removing wisdom teeth is not without controversy – some critics would argue that in the absence of disease or symptoms, patients would be subjected to pain, risk, and unfavorable economic outcome.

However, strong peer reviewed research shows that retained wisdom teeth may involve periodontal pathology (gum disease) despite patients showing no symptoms. The negative impact of periodontal pathology may not be limited to the wisdom teeth region, but rather can have systemic (bodily) affects. Patients with no symptoms also may have carious wisdom teeth, eventually decaying the tooth next to it.

Wisdom teeth should be considered for removal when there is clinical and radiographic evidence of acute or chronic periodontitis (gum disease), pericoronitis (infection and inflammation of excess tissue over the impacted tooth), negative impact on adjacent teeth or not enough space in the jaw forcing the teeth to erupt improperly and grow in sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone.

In most patients, some variation of these findings are present, making the person a candidate for wisdom teeth removal.

In addition, wisdom teeth that are in the area of future jaw surgery or are interfering with orthodontic care also should be removed. All in all, the decision of wisdom teeth removal comes to life in most cases with two doctors bringing their expertise to the table, a general dentist and an oral surgeon. In an orthodontic care scenario, a general dentist, orthodontist, and oral surgeon may work in concert to make a recommendation in the patient’s best interest.

Poorly positioned impacted teeth can cause many problems. When they are partially erupted or have a communication with the oral cavity, the gum opening around the teeth can allow food and bacteria to enter an uncleansible space around the tooth. This condition will eventually cause an infection and/or cavities and gum disease. The result: swelling, discomfort, pain, and illness. The impingement from the incorrectly erupting wisdom teeth may damage other teeth and disrupt the natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of offending impacted teeth might prevent possible future problems of this nature.